Devo Manc
What Does it Mean for Fire and
Rescue?
STEVE McGUIRK CBE, DL
The Plan
The Reality
WHY GREATER MANCHESTER MATTERS…
The GM Strategy: Stronger Together 2013
• GM has two priorities. Sustainable economic growth. And connecting people to that growth, so all benefit
from sustained prosperity
• GM’s economy currently generates £17bn in taxes BUT requires £21 billion in public spending
• Total spend has not changed in real terms, despite the cuts. Reductions in local public spending in
investment and growth But increasing spend on national welfare and health budgets
25.0
22,000
3.2
3.2
21,000
4.8
5.1
£m (2010 prices)
GM expenditure (£bn)
20.0
15.0
7.2
5.9
10.0
5.0
£21.5bn
7.8
8.3
08/09
12/13
£21.2bn
20,000
19,000
18,000
17,000
0.0
16,000
2012-13
2013-14
2014-15
2015-16
Tax income
Benefits and tax credits
Local authorities
Health
2016-17
2017-18
2018-19
2019-20
2020-21
Public spend
Other
• A vision to move GM from being a cost centre to a net contributor to national public finances
• Generating growth and jobs will not be sufficient to meet our ambition and to become a net contributor
to the national economy
The squeeze on all service expenditure
Money available for all other services
Adult Social Care
Waste Management
Children's Social Care
60
50
30
20
10
2019/20
2018/19
2017/18
2016/17
2015/16
2014/15
2013/14
2012/13
2011/12
0
2010/11
£ billion
40
6
HEALTH AND SOCIAL CARE
What is the problem we are trying to solve…?
•
Poorer health
& growth in
chronic
conditions
Instability &
fragmentatio
n in the
health & care
system
A growing
ageing
population
•
•
•
Consequences:
Unplanned, Haphazard
change
Poorer care and
treatment
Difficulty in meeting
future health needs
Failing the health & care
workforce
Increasing pressure on health & social care
….devolution can be the trigger for greater and necessary positive
reform
BUDGET REDUCTION FOR FIRE….OVER 30%
AND MORE TO COME….MUCH MORE?
Fire Total £'m
1200
1057
996
1000
989
914
847
800
600
400
200
0
2010/11
2011/12
2012/13
2013/14
2014/15
2015/16
2016/17
Status quo no longer an option…
How could we have responded…
• Run to stand still: led and managed well but not having the
capacity or resources to deal with major shocks to the system.
• Nostril above the waterline: only able to act with a short-term
view, existing hand to mouth and even a small external change
might seriously challenge viability.
• Wither on the vine: moved from action to reaction, finances and capacity are not sufficient to
the task, retreating into statutory services run at the minimum.
• Just local administration: lost the capacity to deliver
services, either because organisations have 'handed back
the keys' or because responsibility for significant services
has been taken away…OR…BECOME
• Adaptive innovators “Local partners creatively redefining
their role and able to affect their operating environment,
often working in close partnership with other
organisations”
THE GM DEVOLUTION AGREEMENT
New powers received by the Combined Authority:
• Devolved responsibility for business support budgets, making it easier to join up services
to make sure that businesses are able to access the right support at the right time to
help them grow and innovate
• The ability to work with Government to reshape and re-structure Further Education (FE)
provision within Greater Manchester to ensure that the supply of skills in GM meets the
needs of our businesses
• The power and resources to scale up our work on complex dependency pilot to help
50,000 people who have struggled to find work get into jobs
• GM to jointly commission (with the Department for Work and Pensions) the next phase
of the Work Programme, giving us the influence to tailor services to best meet the needs
of our residents
• Work with GM Clinical Commissioning Groups to develop a business plan for the
integration of health and social care across Greater Manchester, allowing us to use
existing health and social care budgets to invest in the community based care needed to
support change
THE GM DEVOLUTION AGREEMENT
New powers received by a directly elected Mayor:
• Devolved responsibility for a joined up and multi-year transport budget, to be agreed at the
next Spending Review
• Responsibility for franchised bus services, including powers over fares, routes, frequency and
ticketing
• The power to introduce integrated smart ticketing across all local modes of transport
• the ability to shape local rail station policy and development across the Greater Manchester
area
• Powers over strategic planning, including the power to create a statutory spatial framework for
Greater Manchester. This will need to be approved by a unanimous vote of the Mayor’s Cabinet
• Control of a new £300 million recyclable Housing Investment Fund
• Control of a reformed “earn back” deal, worth £900 million over 30 years
• The role currently covered by the Police and Crime Commissioner….( subsequently expanded to
encompass Fire and Rescue)
A call to arms….the view of the political leadership
• Amidst the challenge of austerity there is a golden opportunity for radical change in the way
public services are delivered to citizens
• We can mitigate the worst impact of the cuts by moving….
• from expensive palliative, reactive services…
• to cheaper and more effective preventative interventions..
• that are better focussed on what our citizens require….
• and co-ordinated, with sequenced interventions… thus (in theory at least)…
• avoiding the artificial and arbitrary professional and organisational boundaries that have
hampered us in the past
Which means we can be....
• Iconoclasts, innovators and creative collaborators
• More empowered and effective in what we do…
• Deliverers of new more effective ways of working….
• That have a more positive long-term impact on the people we serve
THAT’S THE BIG PICTURE…THE
BIGGEST CHANGE IN A
GENERATION…
BUT WHAT ABOUT FIRE AND
RESCUE?
SOME OF THE HISTORICAL DRIVERS FOR FIRE…
• 1995 – ‘In The Line Of Fire’
• 1997 – ‘Safe as Houses’
• 1998 – ‘Out Of The Line Of Fire’
• 2002 – ‘IRFS, The Future of the Fire Service: reducing risk,
saving lives’ (Bain Review)
• 2002/03 – ‘Industrial dispute’
• 2003 onwards - National Frameworks/ IRMPs
• 2004 – ‘Fire and Rescue Services Act’
• Duty to promote Fire Safety
• 2013 – The Knight Review
• 2014 – Five Year Forward View (Simon Stevens, Chief
Executive, NHS)?
INTEGRATED APPROACH TO REGULATION AND RISK
MANAGEMENT…( we shouldn’t underestimate effectiveness)
KNIGHT REVIEW & GMFRS’ RESPONSE
KEY PRINCIPLES IN CONFRONTING THE FUTURE…
• We recognised that we must deal with the new financial
reality…
• We want to keep Firefighters safe
• We want to keep the Public safe…But…
• We also want to continue to reduce fire damage and the
cost of fire…
• So the only way we can do this is by embracing, adapting
or adopting new technology
• …and by changing fundamentally our approach to safety
in the home and our wider community role
GMFRS Purpose:
To protect and improve the quality of life of the people in
Greater Manchester
“A thousand lives a year could be saved if firefighters responded to cardiac arrests
with defibrillators”
Professor Andy Newton
Director of Clinical Operations, South East Coast Ambulance Service
On average 5% of those that suffer a cardiac arrest in Greater Manchester will
survive, when relying on ambulance attendance alone
NWAS Paramedic Trainer
“250,000 people a year cross the threshold of Accident and Emergency units as a
result of falls”
Simon Stevens, CEO NHS England
FRS ROLE IN A DEVOLVED GREATER MANCHESTER
• Cost of Public Sector in Greater Manchester increasing (Currently £22bn. Almost £6bn
relates to Health & Social Care)
• £1.1bn gap ( and rising) within Health and Social Care budgets
• Fire budget equates to less than 0.5% of Public spend in GM
• Increasing demand on GMP, NWAS and Local Authority Adult Services. Demand on Fire
reducing, despite same demographics!
• Public Sector Reform; traditionally most focus on rationalising response models rather than
upstream prevention
• GMFRS track record in prevention (40+% reduction in demand over 10 years)…very, very
impressive to other partners
FIRE
TRANSFORMATION
NOW PROVIDES A
POWERFUL
NARRATIVE
WHERE CAN WE ADD VALUE?
FRS OFFER TO A NEW DEVOLVED ADMINISTRATION IN
GREATER MANCHESTER
Access to
60,000
homes
Information
sharing
Referral
pathways
Strategic
Commitment
Use of fire
stations
Innovation
Fund
Dedicated
personnel
Community
Risk
Intervention
Teams
FIRE DEMAND
AMBULANCE
DEMAND
SHIFTING ACTIVITY
STAFF
NUMBERS
BROADLY SIMILAR WHOLETIME
ALL HAZARDS RESPONSE?
WHY NOT FIREFIGHTERS?
‘LATENT CAPACITY’?
COMMUNITY RISK INTERVENTION TEAMS (CRIT)
PARTNERS AND SUPPORT
• North West Ambulance
Service
• Greater Manchester Police
• Greater Manchester Police
and Crime Commissioner
• GM Police and Crime Leads
Group
• GM Directors of Public Health
• GM Public Sector Reform
Executive
• GM Health and Wellbeing
Board
• GM Directors of Adult Social
Services
• GM Strategic Safeguarding
Partnership Board
• GM Association of Clinical
Commissioning Groups
• University of Salford
PILOT
• Pilot in 3 Boroughs, Wigan, Salford and Manchester (Dec 14 – April 15)
• Integrate fully with new Health & Social Care arrangements within
Boroughs
• Engage staff from GMP, NWAS and GMFRS volunteers, those returning from
military service and EFCs that have engaged with GMFRS
• Fixed term 20 hr/wk contracts to cover period 0700 – 1900 hours
• Minimum 12 hr/wk out of hours cover provided through ‘on-call’
arrangements
ACTIVITY
• Prevention work 0700 to 1900 – focus on fire, falls, CO, crime
and general detrition in health
• Provide risk reduction equipment at point of contact and
referral to specialists where appropriate
• Response to Falls in the home on behalf of NWAS (manage risk
with a view to casualty remaining at home wherever possible)
• Response to Concern for Welfare relating to mental health on
behalf of GMP
NEXT PHASE FOR CRIT?
• DCLG funding £3.73million awarded in April
• Multi Agency Steering Group maturing
• Expansion across Greater Manchester (one team per borough)
• Phased roll-out post April 2015
• Independent evaluation (in live time) through Salford University
• Cost Benefit Analysis through New Economy
• Estimated £9 Million saving so far from an £898K investment (3
Months)
FIRE AS A ‘HEALTH ASSET’
• FBU now considering a future
role in Public Health
• GM Firefighters asked to be First
Responders to assist NWAS
colleagues…MOU signed
• Firefighters to crew some CRIT
vehicles
• Firefighters & Community Risk
Reduction Teams to complete
Health, Falls, Crime and Fire risk
assessments in the home – Safe
& Well
• Crews to deliver basic CPR
training in schools?
• Responding to some Cardiac
Arrests
DOES IT REALLY MATTER WHO THE FIRST RESPONDER IS?
Its not easy taking everyone with you!
What do you mean it’s a bit muddy?
NOT
EVERYONE
HAS READ
THE SAME
SCRIPT
What really happens
THE FUTURE? EVERYTHING UNDER ONE ROOF?